The Anatomy of Regret: From Death Instinct to Reparation and Symbolization through Vivid Case Studies By S. Kavaler-Adler London:  Karnac, 2013,  272 pp.

Susan Kavaler-Adler is the founder and executive director of the Object Relations Institute for Psychotherapy and Psychoanalysis in New York and the author of several books and many papers in the area of British and American object relations theory and therapy. In the book under review, the author presents in her Introduction, chapter 1, and Conclusion the revised version of Kleinian theory—integrated with concepts of Fairbairn, Winnicott, and Mahler—that informs her view of the therapeutic process as one of “developmental mourning.” It is through facing up to and mourning one's destructiveness (arising, in Kavaler-Adler's view, not from innate aggression but from trauma, broadly defined) and one's consequent regrets, in the context of a therapeutic holding environment, that one is able to liberate oneself from one's defensive and maladaptive “false self” (Winnicott), from one's “antilibidinal ego” or “internal saboteur” (Fairbairn), and from Freud's and Klein's sadistic superego. Having clearly outlined her theoretical framework, the author illustrates it through a series of richly described case studies that, to my mind, demonstrate in clinical detail her theory in practice and its therapeutic power in work with patients suffering from diverse levels and types of psychopathology.